Revision & Failure Total Joint Replacements Higher Among Smokers

Practice Management

Two new studies examining the effects of smoking on patients undergoing total joint replacement showed that smokers have a higher revision rate than non-smokers. The first study compared patients undergoing total knee replacement, finding smokers had a 10-fold higher revision rate. The second study examined patients undergoing acetabulum reconstruction, with a higher rate of failure among smokers than nonsmokers when ultraporous acetabular components were used.

At the American Academy of Orthopaedic Surgeons annual meeting, physicians and specialists participated in a Smoking Cessation Forum and recommended the following:

•    Orthopedic surgeons refuse to perform surgery on patients who smoke; one surgeon reported 40 percent of his patients stopped smoking as a result of this mandate.
•    Ask the patient about whether they smoke, advise them to stop smoking and offer resources for help, such as a free Quitline.
•    Offer smoking cessation assistance to patients who smoke.

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